Blog

On a recent “Making Sense” podcast with Sam Harris, Dr. Nicolas Christakis called for the closing of schools across the United States. Dr. Christakis list of qualifications is extensive: a sociologist and physician, the director of the “Human Nature” lab researching the ways in which (and presumably extent to which) evolution drives human behavior. He has an M.D and a PhD (in sociology). Crucially, he has worked in epidemiology. At a time such as the corona crisis of 2020, he must have much to offer so if he says “close the schools” we should listen: https://www.sciencemag.org/news/2020/03/does-closing-schools-slow-spread-novel-coronavirus

On another recent “The Joe Rogan” podcast, Dr Michael Osterholm called for schools NOT to be closed. See that podcast or here: https://www.washingtonpost.com/education/2020/03/09/is-it-really-good-idea-close-schools-fight-coronavirus/ Dr Osterholm likewise, among his considerable qualifications, lists “epidemiologist”. Unlike Dr. Christakis, however, Dr. Osterholm lists little else among his interests. He is a specialist, not a generalist. He is, crucially, Director of the Centre for Infectious Disease Research and Policy at the University of Minnesota. His life’s work seems to be devoted to: infectious disease epidemics and is a consultant to the World Health Organisation on this.

Dr Amesh Adalja has been more prominent in the media than almost any other expert on COVID-19. He has appeared on The Yaron Brook Show, The Rubin Report, Making Sense, Fox News, CNN and many more besides. He consults with John Hopkins University and has devoted his life to pandemics and biosecurity. He is, again, a very narrow specialist. He has advised against closing schools in a somewhat weaker sense than Dr Osterholm: https://www.livescience.com/should-schools-close-for-coronavirus.html(Other experts at that link agree with the stronger stance of Osterholm)

The “close the schools argument” seems like common sense. After all: kept in a confined space, won’t a single infected student infect all the others? Wouldn’t it be safer to keep them home? “Why don’t they just” questions are aplenty in these times. So "Why don't they just" close the schools?

The argument against closing the schools is harder to make.

If the schools are closed children, who may be infected but show few symptoms, are now, possibly, on the streets. Especially if they are teenagers. Not all parents can “keep their kids inside”. It’s a simple fact, the reality – some number of young people will be at the shops, walking around in the community. They will, by and large, be fine. But the elderly that may cross their paths? The number of severe cases and deaths may increase.

Young children need to be cared for. Who will care for them if not the school teachers? Doctors, nurses, ambulance officers, first responders, pharmacists, other hospital workers, medical receptionists, supermarket workers, etc etc may now be forced to stay home to care for their children.

It is no sin to be a generalist. I call myself one. And in truth there is no “pure specialist”. But it does take all sorts and some people are far more specialized than others and this is never more true than in medicine. I have no expertise whatsoever in epidemiology (nor indeed any kind of medicine) but if I can, perhaps, claim some modest expertise in anything at all, it might be expertise in experts. I make this claim having spent much time speaking with geologists and geophysicists, astronomers, cosmologist and astrophysicists, chemists and philosophers, theoretical physicists and experimental physicists, medicos of a couple of kinds, lawyers of other kinds, engineers and so on. And I’ve noticed over time certain kinds of blind spots as well as astounding levels of depth. There are some experts, among them a very good friend of mine and he won’t mind my saying – a doctor of exceedingly specialized skill that there are perhaps few in the world who can do what he does – and who is so very careful to say when he is out of his depth on areas of medicine outside his narrow area. In the area he is an expert, he will speak with confidence and clear sighted knowledge. He seems to know the danger of making medical pronouncements about things that he covered once long ago in lectures at university or perhaps as a general surgical registrar. He simply recognizes he may not be “up to date” with the latest on whatever medical trouble his friends decide to trouble him with on any particular day. His day to day work is about particular organs and particular troubles and while no area of medicine is utterly disconnected from another, he knows there are others out there to defer to when the organ, mere centimeters away, isn’t the one he is known for treating.

But he is one kind of expert. There are others, and the medical community is not immune to this, where they feel obliged to make public policy pronouncements when the airwaves are already thick with opinions from actual highly specialized experts. Now should such non-specialist “experts” be shut down? Of course not. But it makes things very difficult for the populace and then for actual authorities (the government) to explain clearly the best policy given the best information. It does not take long, in my experience, for astronomers as a group, to be very willing to give all kinds of advice (and it’s usually always the same) when it comes to economics, public policy, climate policy, university administration and so on. There can be a kind of group think among these experts when it comes to areas outside their narrow field of day-to-day work. And, seemingly, the more specialized they become, the more their other opinions tend to conform to the “man-on-the-street” view. That’s not always a bad thing, but perhaps there is a kind of “creativity limit” where they have exhausted their creative thinking for the day whilst at work and when it comes to other matters they fall back onto more prominent memes circulating among their colleagues. It can certainly make the work day easier and socializing with peers less fraught with friction if ones other ideas conform. There are sociological forces at play, of course. But this phenomenon rarely has any serious effects – but in a time of crisis it may be deadly.

The word “expert” is a sliding scale. I trust none of them. But then I have taken on Fox Mulder’s maxim “trust no one” to the core. An expert is someone whom I know (fallibly, as always) has gone though experiences and gained the knowledge via a process of error correction through encounters with reality in the narrow domain within which they call themselves an expert. People like Dr Osterholm and Dr Adalja are the real deal. They are actual infectious disease experts who have worked on outbreaks like SARS-1, MERS and Ebola and tested their theories in the field with WHO and the CDC and so on. They have not merely read the literature or know the theory or kept up to date with the latest texts. They have been actively involved in situations before that are the closest thing to what we face now - at the coal face on these kinds of things. The average M.D, “General Practioner” or even PhD in epidemiology or (especially!) PhD in Mathematical Modelling of Epidemics are not the primary people for government (and media, mind you) to be consulted. Not in the first instance. Secondary people: sure. Helpful in some general sense to critique the primary critiques. But they should seek to clarify not add to the noise and at a time like this, not publicly “think on their feet”. And they should be challenged whenever their pronouncements diverge from that of the primary experts. At best the secondary people should act as knowledgeable conduits of the primary people. If they think they have better ideas: wonderful. They should not be backward in coming forward. But they should likewise have first considered what those primary experts have said. The secondary people should have gone through a careful process of error correction alone, or with their close circle of collegues before going public with some kind of advise to government and others with things like “close the schools” when the top tier specialist people are saying otherwise.

Not all people called experts are expert in the specific thing in question. Not all are highly specialized and have devoted their life to, essentially, one thing and had it tested in reality and not merely in some theoretical model. And no expert is an “authority” which is to say: none should ever have the power to shut down debate or direct people against their will. No one should ever do that.

However, in a democracy, we have elected officials – politicians – who we have decided can exercise such a power in a crisis. This power should never be delegated and should be used only in extremis. We are not yet “in extremis”. Times are urgent and the word “crisis” is apt. But this is no time to leave behind a sensible concern about which people we can best assume have the knowledge to guide us through.

It is rather like we are all on an Airbus A-380 and the announcement comes over the PA system from the chief steward “This is an emergency. There is a fire in an engine and (by remarkable coincidence) the 4 pilots have all fallen gravely ill. We must make an emergency landing. Are there any pilots on board?”

5 people step forward to help.

The first is a mathematician who has flown 10,000 hours on an A-380 flight simulator.

The second is a light aircraft pilot with 5000 hours experience in a Cessna.

The third is a Learjet pilot with 8000 hours experience.

The fourth (you can see where I am going with this) is an A-320 captain who is learning to fly the A-380 and has clocked up 1000 hours.

And the fifth is Captain Richard Champion de Crespigny - a 15000+ hours experience A-380 Qantas pilot being shuttled back to his home airport and who successfully landed QF-32 when one of the engines caught fire in 2010.

It is a wonderful thing the passengers are so fortunate that day to have such a wealth of people to advise them. But though experts according to some broad definition of the word, they are not all "equal" by any means. There is clearly a “best person for the job”.

Without the fifth person, I would happily take the advice of number 4. But given the fifth person, and given I know nothing about how to fly a jet of any kind, if there is a dispute between number 5 and any of the others (or even all of the others) I will defer to number 5. Even better if I can understand the debate and 5 sounds reasonable. This is no matter of consensus because the 400 passengers on board may well be serious adherents of the religion of the Spaghetti monster and may vote to turn off the engines and attempt a safe glide into the holy Spaghetti pond.

And we need not “obey” the expert here as an authority. Upon safely landing, should our number 5 A-380 Captain then proclaim, upon the tarmac, to indefinately remain on board and wait patiently for the fire brigade as flames began to lick at the windows, I would disobey and help others seek to open the emergency escape for I know enough about aircraft and fuel tanks and fires to know that time is of the essence. I need no "expert" for that kind of thing. There are good reasons to defy an expert (see the actions of the Captain of the South Korean tragedy of the "Sewol ferry" for more on that kind of thing.) Experts can be wrong just like the rest of us but unlike the rest of us are more able to reliably and routinely convey to the rest of us the best available knowledge at any given time. They are not there as inerrant authorities and they should not be expected never to err. That too is a hazard of the “authority” moniker. It means that if the “authoritative expert” makes an error – as surely they will like the rest of us – they should not be blamed unless they have done less than their best. For their best really will be THE best at the given time. That’s what it means to be an expert. They too can fail.

So should we close the schools or not? The striking thing about the split among the experts is that the more specialized in infectious disease outbreaks, it seems the more likely the expert is to advise “no” with caveats and a seeming willingness to change if new evidence is found. But with the generalists: the trend seems to be to advise “close them now” with few caveats. But those generalists risk little because in general they aren’t advising those making those calls.

But we should be there to back them to try again, and again, because at times like this, that’s our best bet.

I was driven to this post by running out of toilet paper and being unable to find any at supermarkets near my house so walked in the rain to the next suburb over to only have to push past people filling whole trolleys with packets of 9 double length rolls as shelf stackers restocked…

Have an opinion on the severity of this virus after listening to an expert. Like this guy. He is a scientist who specializes in viruses like this and advises the US government on outbreaks like this.

I think everyone who wants to venture strong opinions on this virus - including having strong opinions on whether to stockpile things - should either be an expert or watch someone who is, like this guy. But if you cannot do that much, here are some takeaways:

The death rate for Corona (COVID-19) way way less than 1%.

Over 80% of cases are mild…many people won’t even realize their 2-day long sniffle was corona-19.

Its R0 value (how contagious it is = how many people an infected person will typically infect) is relatively low at 2.0 to 2.4. Measles, for example, has an R0 = 15.

Politicians shouldn’t comment on things they have no idea about. Eg: when Bernie Sanders criticized a pharmaceutical company some time ago, so they stopped working on a vaccine for a related virus due to all the bad publicity…so we don’t have all the vaccines we might have had.

Wild animals are a key way these viruses spread. All corona viruses originate in bats but then end up in some other animals and only then in people. Eg: MERS which was a worse form of corona was transmitted by camels. MERS had a 35% death rate but was far far more difficult to spread human-to-human but EASY to spread camel-human.

There is a “severity bias” with COVID-19. This means you only hear about the very small number of severe cases because they end up in hospital being tested. Most people who get it – you included – would probably never know you had it.

In 2009 the H1N1 virus looks like it was worse. In the US alone well over 200,000 infections and 12,000 deaths. This new one looks to be “mild to moderate” – it won’t “go away”. Viruses are just a part of life. This coronavirus may end up “endemic”: we may just have to live with it for years.

The Australian government is overreacting. We cannot contain it. We just have to be resilient and help the rare people who get really sick. Politicians tend not to get punished for over reacting on these things. But they should. China overreacted majorly, according to this expert, because the virus could never be contained and now it sets a bad example for other countries and when it breaks through the containment people will think that containment never works. It does…but not for this virus.

Masks are not needed for the general public.

This virus is especially not severe for children.

Wash your hands.

Modern healthcare systems really reduce fatality rates. Eg: ebola was thought to have a 90% death rate….but simply giving people IV fluids in a hospital reduced that number to 20%.

The main effect on the economy is due to misinformed shutdowns by the government.